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Lawn Mower Safety

LawnmowerAs you begin assigning chores to your children this summer, there are few things to consider about yard work and lawn mower safety.

“We see quite a few patients in our emergency room during the summer because of lawn mower injuries,” said Dr. Terri Coco, pediatric emergency medicine. “Most typical are skin lacerations and injuries to extremities, such as their hands and feet. We also see some eye injuries when items like rocks or sticks are picked up and thrown by a lawn mower.”

In general, children should be at least:

  • 12 years old to safely operate a walk-behind power or hand lawn mower
  • 16 years old to safely operate a riding lawn mower

When you decide your child is ready to use a lawn mower, spend some time with them reviewing the equipment’s owner manual in advance and talking about how to do the job safely. The most important thing, said Dr. Coco, is parental supervision.

“Lawn mower injuries can be severe. These types of injuries require many surgeries involving many specialists, especially when the goal involves saving a limb,” Dr. Coco said.

Before mowing:

  • Inspect the area to be cut, and remove any items that could be picked up and thrown by the lawn mower.
  • Ensure your lawn equipment is in good working condition.

While mowing:

  • Use sunscreen, safety glasses or goggles, closed-toe shoes and hearing protection.
  • Small children should be a safe distance away while the lawn mower is in use.
  • Never allow children to ride as passengers on a riding lawn mower.
  • Avoid mowing in reverse.
  • Push or drive your mower up and down slopes, not across, to prevent mower rollover.

After mowing:

  • When you turn your mower off, make sure the blades are completely stopped.
  • Only refuel the mower once the engine has cooled.

A lawn mower is a very powerful tool. It can cause serious injuries, but many of these injuries are preventable. Keep your children safe around lawn mowers this summer. Following these guidelines can help prevent lawn mower injuries.

Playground Safety

Children love to play on the playground. Playgrounds offer youngsters an opportunity to be outside, play with friends, and get some exercise. Play is incredibly important to the development of children’s social, emotional, cognitive and physical development, as well as creativity and imagination. But unfortunately, each year, more than 200,000 children are treated at hospital emergency rooms for playground related injuries. Many of these accidents are preventable.

Teri Coco, MD, is a physician in the emergency department at Children’s of Alabama. She says parental supervision is the best way to prevent playground accidents. Adult supervision can help prevent injuries by making sure kids are using playground equipment properly and aren’t engaging in any unsafe behavior on the playground.

“Watch your children. Be aware of where they are, what they’re going down, what their climbing on.”  Playground equipment should be age appropriate. Little ones should play on playgrounds that are designed for their size and abilities. These are usually smaller and are lower to the ground than full- size playgrounds. “You want to watch that what they’re playing on is developmentally appropriate,” Coco said. “So for those children who are less than 2 to 3 years of age, you want to look at that equipment when you get there. Be sure it’s low to the ground, that there are no monkey bars.  The slides should be very low and the surfaces of the equipment should be smooth.”

Small children are also safest if they are playing in their own area, not mixed in with bigger children   who could knock them over. But adult supervision shouldn’t just be limited to the younger children. Older children may test their limits on the playground, so it’s important for parents to keep them in check.

Coco says, the parent should walk around before allowing their children to play on the playground to see that everything is safe. They should check the surface of the playground to be sure there are no exposed nails or twisted metal. Adults should also look for things like broken glass under or around the playground. Coco also recommends feeling the surface of slides to be sure they’re not too hot. The old days of a playground built on top of asphalt or concrete should be over. A hard surface is extremely dangerous in the event of a fall. “The harder the surface is, the more serious the injury is going to be when they fall,” Coco said. Grass, soil and packed earth surfaces are also unsafe and unacceptable because weather and wear can reduce their capability of cushioning a child’s fall. Recommended surfaces include wood chips, mulch, pea gravel or shredded rubber.

Coco said it’s always best for even the older children to avoid more dangerous playground equipment like monkey bars. Parents should also instruct children how to play properly. They should make sure children slide feet-first, not head-first, down slides, and watch that they are using swings properly. They should also make sure children aren’t pushing or rough housing while on the playground.

Parents should encourage their children to play on a playground. Play is an important part of their physical, social, intellectual and emotional development. But it’s important that a parent is always present to watch out for potential dangers and to ensure that their children can play safe.

Dance Medicine is a Growing Specialty at Children’s

Dr. Reed Estes is the Chief of UAB Sports Medicine at Children’s of Alabama and an Assistant Professor at UAB. He treats young athletes, and has developed a growing specialty in dance medicine. He has worked with performers in the Boston Ballet and many other professional and amateur dance companies.

Dance, like any other physical activity, produces its share of injuries, particularly in children Dr. Reed Estes and patientand teenagers. There are sprains, strains, broken bones, bumps and bruises. The more serious injuries often require specialized care and rehabilitation aimed at getting dancers back on their feet and toes. It’s important to understand when and why this specialized care is needed.

Dance injuries account for a steadily increasing volume of my sports medicine practice at Children’s of Alabama. We provide and coordinate care across the many specialties at Children’s, and we work closely with Agile Physical Therapy, which greatly enhances our ability to serve dancers. We conduct clinics at dance studios, and see patients from throughout the southeastern U.S.

Dance injuries are fairly common. On average, 23 children are treated every day in U.S. emergency rooms for some type of dance-related injury, according to a recent study published in the Journal of Physical Activity and Health. That same study also found that the number of serious, dance-related injuries increased 37 percent from 1991 to 2007, climbing from 6,175 to 8,477 annually.

Some dancers come to us just to be checked when approaching a new, more difficult level of performance, such as beginning pre-pointe participation with ballet. Others have been injured, and come to us for specialized care. We understand the mentality of dancers and the things they need to prepare for. It’s considerably different than the way we treat our football players or soccer players.

For example, when a football player tears his anterior cruciate ligament, or ACL, we focus rehabilitation on strengthening his core movements to get him back on the field, specifically to the demands required of a contact athlete. In dance, there are different requirements. A dancer must not only be limber and able to accomplish difficult tasks in an aesthetically pleasing manner, but also maintain full stamina. Rehabilitation for a dancer focuses on that.

Not all injuries require a dance medicine specialist. I tell patients and families to watch for pain that is ongoing, persistent and may be causing disability. Pain that is present with one particular activity, every time it occurs, may indicate a need for medical intervention. Likewise, pain that progresses with a decreasing level of activity often poses a warning sign.

Of course, the best medicine is prevention, and there are things that parents can do with a child who is a dancer. Watch for fatigue, monitor dietary habits, ensure that sleep is sufficient and know when a child or teenager is under stress with projects at school. Understand how that affects them when they are in the dance studio, when they are under duress and fatigued. Young dancers tend to eat poorly and not

get enough sleep before performances when life becomes stressful. There’s only so much time in the day to practice and do homework.

Many times, teenage dancers will remain silent when they are injured. There is often a fear that their instructor may be upset with them, their classmates may lose faith in them, or they may lose their roles in performances. Oftentimes, it requires the parent watching closely and saying, “I noticed my daughter was icing down her ankle or rubbing down her knee.” Parents should be mindful of those things.

Also, we encourage parents to watch for the level of pain after dance. We usually advise that a low level of pain is acceptable some of the time. That’s a 4 or 5 out of 10, on occasion, and is often a symptom of soreness, as opposed to something that is more persistent.

Remember, most sports are seasonal, but dance is a year-round pursuit with little downtime. Thus, my mentality has to change when treating a dancer.

Cutting Sugar

Most parents at some point have uttered the phrase, “My child has such a sweet tooth!” And yet few parents do anything about it.  We hear time and again that children have too much sugar in their diets. Cutting sugar isn’t a simple task. But it’s an important one.

“One third of children in the U.S. are affected by overweight and obesity,” said Beverly Haynes, RN, nurse clinician in the Weight Management Clinic at Children’s of Alabama. “We know that this leads to a multitude of even more serious diseases such as hypertension, diabetes, heart disease, liver disease, joint problems and many more.”

One way to cut down on sugar is to reduce or eliminate the obvious offenders. Parents can easily restrict candy and products like maple syrup, honey and jellies. Eliminating sugar-sweetened drinks like sodas and fruit juices alone can make a huge impact! Consider these facts:

  • Each 12-ounce serving of a carbonated, sweetened soft drink contains the equivalent of 10 teaspoons of sugar and 150 calories. Sweetened drinks are the largest source of added sugar in the daily diets of U.S. children.
  • Consuming one 12-ounce sweetened soft drink per day increases a child’s risk of obesity.

But it’s important to know that many foods contain “hidden sugars.”  Products not normally considered “sweet” can have a lot of sugar in them.  Examples are peanut butter, salad dressings, and ketchup.

In addition, the carbohydrates in highly refined foods with simple sugars, such as white flour and white rice, are easily broken down and cause blood sugar levels to rise quickly.  Complex carbs, found in whole grains, on the other hand, are broken down more slowly, allowing blood sugar to rise more gradually.

According to Beverly, the best source of sugar is fruits and vegetables.  Instead of soda or juice drinks, serve low-fat milk, water or 100 percent fruit juice. A word of caution: although there’s no added sugar in 100 percent fruit juice, the calories from those natural sugars can add up. So limit juice intake to 4-6 ounces for children under 7 years old, and no more than 8-12 ounces for older kids and teens.

To find out if a food has added sugar, look at the ingredient list for sugar, corn syrup or sweetener, dextrose, fructose, honey or molasses. Avoid products that have sugar or other sweeteners high on the ingredient list.

Children’s weight management experts will never tell a patient they can’t enjoy an occasional slice of birthday cake. Occasional treats are okay. The key is that parents are aware of the amount of sugar in their children’s diet, and that they stay informed by reading the labels on foods and setting limits. Above all, it’s important for parents to be a good role model. Kids will see mom and dad’s wholesome habits and adopt them, leading to a healthier lifestyle throughout childhood and into adulthood.

Carbon Monoxide Dangers

While carbon monoxide may come to mind more frequently during winter months, it’s actually a year-round hazard. Knowing how your family can be exposed to carbon monoxide can keep them safe from this colorless, odorless, tasteless, poisonous gas.  carbonmonoxide

Carbon monoxide is produced when you burn fuel in cars or trucks, small engines, stoves, lanterns, grills, fireplaces, gas ranges or furnaces.  It is one of the leading causes of poisoning deaths in the United States. Carbon monoxide poisoning accounts for approximately 40,000 to 50,000 emergency room visits and 5,000 to 6,000 deaths annually in the United States. Yet all instances of carbon poisonings are preventable.

“Carbon monoxide detectors should be installed in addition to smoke detectors. If your smoke detector goes off and there is a fire, you could be exposed to carbon monoxide. However, you can be exposed to carbon monoxide even if there isn’t a fire. That’s why it’s so important to have both a smoke and carbon monoxide detector in the home,” said Ann Slattery, DrPH, RN, RPh, CSPI, DABAT, managing director, Regional Poison Control Center at Children’s of Alabama.

If your carbon monoxide detector goes off:

  • leave the home and immediately seek fresh air
  • call 911 for the fire department to inspect the home
  • call the Poison Control Center at 1-800-222-1222 if there are signs and symptoms of carbon monoxide exposure

The most common symptoms of carbon monoxide exposure are headache, fatigue, dizziness, weakness, nausea, vomiting, chest pain and confusion.

“One of the hallmarks of carbon monoxide exposure is multiple people sick at the same time. Unlike a virus that takes its time working through the household, carbon monoxide will affect everyone in the home at the same time.” Slattery said.

As warm weather approaches, you may already be thinking about your favorite outdoor activities. Keep in mind that you could be exposed to carbon monoxide through:

  • Generators — Don’t use a generator inside the home, garage or basement or near windows. Spring often brings severe weather to Alabama, so be cautious when using a generator during a power outage.
  • Grilling — Never burn charcoal indoors or use a portable camp stove in a garage.
  • Camping — Never use a kerosene lantern inside a tent.
  • Boating — Carbon monoxide from engine exhaust builds up inside and outside the boat in areas near exhaust vents. Swim and play away from areas where engines vent their exhaust. Dock, beach, or anchor at least 20 feet away from the nearest boat that is running a generator or engine. Exhaust from a nearby vessel can send CO into the cabin and cockpit of a boat.
  • Gasoline-powered tools — Never use gasoline-powered tools such as pressure washers and leaf blowers indoors or in a garage, carport or basement. These tools can produce significant amounts of carbon dioxide that can quickly build up to dangerous levels.

The Regional Poison Control Center at Children’s of Alabama was established in 1958. The center handles more than 50,000 poison calls annually, plus more than 60,000 follow-up calls. For more information, visit https://www.childrensal.org/rpcc.

 

Car Seat Safety for Every Age

Car seat safety isn’t just an area of concern just for parents of newborns. As children grow, it is important that they are in an appropriate car seat based on their size.carseatInstall

“There’s no magic one-size-fits-all car seat, so parents need to be familiar with the specific weight and
height limitations of their child’s car seat,” said Marie Crew, coordinator of Safe Kids Alabama and the Child Passenger Safety Resource Center. “A car seat keeps your child in the best seated position for a potential crash.”

Each year, thousands of children are injured or killed in car crashes. Because of children’s bone development and the size of their heads in relation to their torsos, their bodies can be easily injured in a car crash.

A car seat can:

  • hold your child securely.
  • protect your child from hitting something in the vehicle
  • absorb the force of a sudden stop
  • spread the force of an impact safely
  • prevent your child from being crushed by other passengers.

The right seat doesn’t have to be the most expensive one in the store. “When you’re researching seats, check to see what is the highest weight and height the seat can handle. Determine which model your child can use for the longest amount of time,” Crew said.

INFANTS & TODDLERS
All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years old or until they reach the height and weight limits of the seat. Safety experts say rear facing is the safest way for children to travel because it is the best way to prevent head and spinal cord injuries. The most common types of vehicle crashes are from the front or side. Therefore, children who ride in a rear-facing seat have the maximum protection for the head, neck and spine.

TODDLERS & PRESCHOOLERS
When a child has outgrown a rear-facing seat, he should transition to a forward-facing car seat with a harness and top tether until they reach the height and weight limits of the seat.

 

SCHIOOL-AGED CHILDREN
Children who have reached the height and weight limits of their forward-facing car seat should ride in a belt-positioning booster seat until a safety belt fits properly. Seat belts don’t fit children properly until they are at least 4 feet 9 inches and weigh between 80 to 100 pounds, usually between 8 and 12 years old. With a booster seat, the lap belt should fit low across the child’s hips, and the shoulder belt should fit across the shoulder. Children seated in a booster seat in the back seat of the car are 45 percent less likely to be injured in a crash than children using a seat belt alone.

The safest place for all children under the age of 13 is in the back seat of the car.

Parents and other adult drivers can set a good example by buckling up for every single car ride. When children see you use seat belts, you are helping develop lifelong safety habits.

For more child passenger safety tips, www.childrensal.org/ChildPassengerSafety.

Tanning Beds or Sunlight?

It’s that time of year when students get ready for Spring Break and fun in the sun.  Unfortunately, as many teens begin to trade their winter coats for shorts and t-shirts, they may head to the tanning bed to recreate that warm glow.

In fact, some may think going to a tanning bed is safer than being in the sun, since the exposure time is only about 10 minutes.  However, the experts at Children’s of Alabama say the use of tanning beds is why physicians are treating more and more young people for skin cancer.

Indoor Tanning vs. Sunlight

The sun’s rays contain two types of ultraviolet radiation that affect your skin: UVA and UVB.  Tanning beds use UVA light, which penetrates the skin more deeply than UVB rays.  So tanning beds can cause just as much – if not more – damage as the sun.  Plus the concentration of UVA rays from a tanning bed is greater than the amount of UVA rays a person gets from the sun.

Types of Skin Cancer

Studies show that users of tanning beds have much higher risks of basal and squamous cell carcinoma, the two most common types of skin cancer. Doctors also know that young people are more at risk for melanoma, the most serious kind of skin cancer. Melanoma that’s caught early, when it’s still on the surface of the skin, can be cured. But undetected melanoma can grow downward into the skin until it reaches the blood vessels and lymphatic system. These two systems can act like a highway for the cancer cells, allowing them easy access to distant organs like the lungs or the brain. That’s why early detection is so important.

It used to be that mostly older people got melanoma, but doctors are seeing more people in their twenties and even younger with serious cases of skin cancer.  Among teens and young adults, there is an eight- fold higher risk of melanoma among tanning bed users, due to their exposure to concentrated doses of UV rays.

How to Recognize Skin Cancer

There are things you can do to help with early detection of skin cancer, said Traci Duncan, CRNP, a certified nurse practitioner at Children’s of Alabama. “The most important thing is to know your skin, and be familiar with your moles. Know whether a mole has undergone any kind of recent change, whether it’s in size, shape or color.” 

Minimizing Your Risk

The good news about skin cancer is that you have the power to substantially reduce your family’s risk of getting it by taking sun safety seriously.

  • Avoid the strongest sun of the day — between 10 a.m. and 4 p.m.
  • Use broad-spectrum sunscreen (SPF 15 or more) whenever you’re in the sun.
  • Wear a wide-brimmed hat and cover up with long, loose cotton clothing if you burn easily.
  • Stay out of the tanning salon. The risk of developing melanoma is eight times greater among people who use tanning beds regularly.
  • Regularly check for moles and any changes on your family’s skin

Remember, you don’t have to go without a sun-bronzed look. The new generation of self-tanners and body makeups offer easy, realistic results at a reasonable price. Just be sure to use a daily sunblock with an SPF of at least 15 when you go outdoors since fake tanners don’t protect you against sunburn or sun damage.

However, it’s a good idea to avoid airbrush or spray on tans. “The FDA hasn’t approved DHA, the main ingredient in self-tanners for use internally or on mucous membranes like the lips,” said Duncan.“Spray tans may have unknown health risks because people can breathe in the spray, or the tanner may end up on their lips or eye area.”

By taking these precautions, you can insure your family’s skin truly is healthy.

Dr. Robert Cantu talks Concussions

Dr. Robert Cantu, Photo Credit: News Hour

Dr. Robert Cantu, credit News Hour

Dr. Robert Cantu is one of the world’s foremost authorities on brain trauma and concussions in sports. He will speak at our second annual Concussion Summit on Friday, Feb. 27. Dr. Cantu is the author of “Concussions and Our Kids – America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe.” He is also Senior Advisor to the NFL’s Head, Neck and Spine Committee, Co- Founder and Medical Director of the Sports Legacy (SLI) Institute in Waltham, MA; Medical and Research Director of the Cantu Concussion Center, Concord, MA and Professor of Neurology and Neurosurgery at Boston University School of Medicine.  We asked Dr. Cantu a few questions about what parents need to know about concussions.

How do you know if your child has suffered a concussion? Even if they seem fine, what are some signs and symptoms that may develop later, after the athlete gets home?
The athlete may be sleepier than usual and several days post-concussion may have trouble falling and staying asleep and sensitivity to light or noise by day two or three. Kids are more irritable and have a shorter fuse after a concussion. Concussion symptoms like headache and dizziness can get worse and if they do, a doctor needs to assess the athlete.

What is the most important thing coaches, parents, schools and athletes need to know about concussion and its short and long-term effects?
The most important thing to understand is if properly managed, the overwhelming majority of people will be over concussion symptoms within 8 – 10 days. However, if the concussion is improperly managed, and the athlete remains physically active while symptomatic, they run the risk of second impact syndrome, which can have catastrophic consequences.

Since you are an adviser to the NFL, you get the chance to share your expertise with people at the highest level of the game. What would you say to the little league, middle school and high school athletes (or their parents) who want to be that “star player” – who don’t want anyone to see that they are truly shaken up on the field or on the court?

I want them to understand that playing through a concussion could have dire consequences, including death. If they are properly treated, the time away from their sport while they recover will be lessened.

Registration is still available for the 2015 Concussion Summit – visit http://bit.ly/1aebNnH to sign up.

Preventing and Treating Diaper Rash

Everyone wants a happy, healthy baby, but if your little one is in diapers, then it’s inevitable at some point he or she will likely have a diaper rash.  Diaper rash is a common condition that usually occurs because a baby’s sensitive skin has been irritated by diapers that are left on too long. The same plastic that prevents diapers from leaking also prevents air circulation, thus creating a warm, moist environment where rashes and fungi can thrive.

Diaper rash can be very uncomfortable for a little one, and in some cases may require medical treatment. Some signs of a diaper rash can include:

  • Soreness
  • Redness and red bumps
  • Peeling
  • Irritability

Identifying Infection:

Sometimes a diaper rash can also result in an infection due to yeast or bacteria. Seek medical care if your baby has any of the following symptoms:

  • Blisters or open sores
  • Pus filled sores
  • Fluid seeping from red areas

Traci Duncan is a Certified Nurse Practitioner at Children’s of Alabama with a focus on pediatric dermatology. She says the best way to treat and even prevent diaper rash is to use a barrier cream. Specifically, she says look for diaper rash creams that contain Zinc Oxide to heal and protect your baby’s skin. Duncan recommends smearing the cream on in a thick layer, as if icing a cake at each diaper change.

Types of Treatment:

  • Diaper rash creams with Zinc Oxide
  • Petroleum Jelly

Diaper rash can usually be cleared up by checking your baby’s diaper often and changing it as soon as it’s wet or soiled.  With treatment, the rash should usually go away within 2 or 3 days with home care.  If the rash persists, or if sores appear talk to your baby’s doctor.  You should also seek medical advice if the rash is accompanied by a fever, if there is pus draining from the rash, or if your child is irritable.

Prevention:

Duncan says in some cases, when a baby has sensitive skin, diaper wipes may cause irritation.  She recommends only using wipes in the case of a soiled diaper, not when it’s wet.  Instead, she says use a soft cloth and warm water when it’s just a wet diaper. Then allow the baby’s skin to dry completely before putting on a new diaper. Consider using a barrier diaper cream with each change, if the baby is prone to getting diaper rash.

The following are tips to help prevent diaper rash:

  • Keep the skin dry
  • Allow your baby time without a diaper
  • Change diaper frequently
  • Use warm water and diaper cream with each change

With these simple tips you can help ensure your baby stays comfortable and rash free, which makes for a happy baby and a happy mom and dad.

Pediatric and Infant Center for Acute Nephrology

Dr. David J. Askenazi is medical director of the Pediatric and Infant Center for Acute Nephrology (PICAN) at Children’s of David AskenaziAlabama and Associate Professor of Pediatrics at the University of Alabama at Birmingham (UAB). The PICAN Center works to improve the health and care of infants and children who are at risk for acute kidney disease.

Hospitalized children are at great risk to develop abrupt loss of kidney function. The risk factors for acute kidney injury include toxic side effects from drugs administered to treat a critical illnesses, shock from sepsis, decreased blood flow around the time of surgery and congenital conditions. Reducing those risks, and supporting the failed kidney during this time is the job of the Pediatric and Infant Center for Acute Nephrology (PICAN Center) established a year ago at Children’s of Alabama.

We take a three-pronged approach:

  • Clinical services, which strive to provide the best of care
  • Educational outreach here and throughout the country, which trains physicians and nurses to diagnose and support those with acute kidney damage
  • Research, which leads to a better understanding of the diagnosis, risk factors and outcomes and develops new strategies for prevention and treatment

This all requires coordination and cooperation not only within Children’s but throughout other pediatric care centers at home and abroad.

We are now leading the Neonatal Kidney Collaborative, an international group of more than 20 centers that are interested in the topic of neonatal kidney problems. This collaborative has emerged from observations and studies showing that babies in neonatal intensive care units frequently develop acute kidney injury. It’s not surprising. Normally, babies develop a full complement of nephrons—functional units that make up our kidneys—during the first eight months in the womb. After that, we no longer produce nephrons. However, when born prematurely, nephron production cycle is cut short and babies can end up with fewer nephrons than normal. That can make them more susceptible to short and longterm problems including chronic kidney disease and high blood pressure. By collaborating with other centers, we can look at much broader demographics and much larger numbers of patients, which will allow us to make stronger inferences. Our first study launches in March and will be titled AWAKEN (Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates. This study will improve our ability to diagnose acute kidney injury, understand risk factors, and determine how fluid provision affects kidney and other outcomes.

Meanwhile, Children’s has joined eight other hospitals nationwide to implement a program called NINJA (Nephrotoxic Injury Negated by Just-in-Time Action). This quality improvement project screens every patient admitted to the hospital for medications known to have toxic side effects to the kidney. Historically there has been a tendency to accept this damage as necessary, but we are showing that with risk assessment and daily evaluation of the medications we give our patients, we can reduce the incidence and severity of acute kidney injury. The pharmacy “NINJA’s” look through the hospital census daily and find those who with high risk of toxicity, then they work with care teams to minimize use of these medications, monitor levels of kidney function and to ask the question: “Is it in the best interest of this patient to be on this medicine?” By paying close attention to these risks, we can make a difference in the occurrence or severity of an acute kidney injury.

There are many other initiatives involving our center but one in particular is worth mentioning. It involves a dialysis machine that we are employing for babies. In the past we have relied upon adult dialysis machines for dialyzing babies with kidney failure. Because these machines are not designed for babies, they carry added risk of bleeding and low blood pressure. So we found an opportunity to work with an FDA-approved machine called the Aquadex FlexFlow. It was designed to remove fluids from patients with heart failure but it also happens to be the right size to use on babies. We’ve adapted the machine in the intensive care units of Children’s of Alabama to clean a baby’s blood, remove extra fluid and balance electrolytes. We have been able to do this while avoiding the risks inherent to adult-sized dialysis machine.

Visit our website at www.childrensal.org/pican for more information.

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